| 邢东倩,吴晓明,罗翠香.颈脊髓损伤病人颈椎前路减压融合术后感染的影响因素及预警模型.骨科,2025,16(6): 488-493. |
| 颈脊髓损伤病人颈椎前路减压融合术后感染的影响因素及预警模型 |
| Influencing factors and warning model for infection after anterior cervical decompression and fusion surgery in patients with cervical spinal cord injury |
| 投稿时间：2025-04-01 |
| DOI：10.3969/j.issn.1674-8573.2025.06.002 |
| 中文关键词: 颈脊髓损伤 颈椎前路减压融合术 感染 影响因素 预警模型 |
| 英文关键词: Cervical spinal cord injury Cervical anterior decompression and fusion surgery Infection Influencing factors Warning Model |
| 基金项目:河北省卫生健康委员会科研计划项目（20241027） |
|
| 摘要点击次数: 75 |
| 全文下载次数: 0 |
| 中文摘要: |
| 目的 探讨颈脊髓损伤（CSCI）病人颈椎前路减压融合术后感染的影响因素，并建立预警模型。方法 选取2022年1月至2024年1月衡水市第四人民医院收治的163例CSCI病人纳入研究，统一行颈椎前路减压融合术。计算本组病人术后3个月的感染发生率，采用单因素和多因素Logistic回归分析术后感染预测因素，建立列线图预警模型，并进行内部验证。结果 术后3个月，41例（25.15%）CSCI病人出现感染。术后感染与未感染病人在受伤至入院手术时间、美国脊柱损伤协会（ASIA）分级、手术节段数、术前是否使用激素冲击疗法，以及血清C反应蛋白（CRP）、降钙素原（PCT）、血清淀粉样蛋白A（SAA）水平方面的差异有统计学意义（P＜0.05）。Logistic回归分析结果显示受伤至入院手术时间、术前使用激素冲击疗法、ASIA分级、SAA、PCT均是CSCI病人术后感染的影响因素（P＜0.05）。受试者工作特征（ROC）曲线显示列线图模型预测CSCI病人术后感染的ROC曲线下面积（AUC）为0.942（95% CI：0.910，0.975），敏感度92.68%，特异度86.89%；校准曲线及决策曲线提示列线图模型校准效果及临床适用性较好。结论 CSCI病人颈椎前路减压融合术后感染风险较高，受伤至入院手术时间、术前使用激素冲击疗法、ASIA分级、SAA、PCT是其影响因素，该预警模型具有较好的预测能力，可筛选识别高危人群，为临床防控干预提供指导。 |
| 英文摘要: |
| Objective To explore the influencing factors for infection after anterior cervical decompression and fusion surgery in patients with cervical spinal cord injury (CSCI), and construct a warning model. Methods A total of 163 CSCI patients admitted to Hengshui Fourth People's Hospital from January 2022 to January 2024 were selected for the study and underwent cervical anterior decompression and fusion surgery. The incidence of infection in CSCI patients at 3rd month after surgery was calculated, univariate regression and multivariate Logistic regression were used to analyze the predictive factors of postoperative infection, and a column chart warning model with internal validation was constructed. Results In total, 41 CSCI patients (25.15%) developed infections at 3rd month after surgery. There were statistically significant differences (P＜0.05) in the time from injury to admission surgery, American Spinal Injury Association (ASIA) classification, number of surgical segments, preoperative use of hormone shock therapy, as well as serum C-reactive protein (CRP), procalcitonin (PCT), and serum amyloid A (SAA) levels between postoperative infected and uninfected patients. The results of Logistic regression analysis showed that time from injury to admission for surgery, preoperative use of hormone shock therapy, ASIA grading, SAA, and PCT were influencing factors for postoperative infection in CSCI patients (P＜0.05). The receiver operating characteristic (ROC) curve showed that the area under the ROC curve (AUC) of the column chart model for predicting postoperative infection in CSCI patients was 0.942 (95% CI: 0.910, 0.975), with a sensitivity of 92.68% and a specificity of 86.89%. The calibration curve and decision curve indicated that the column chart model had good calibration effect and clinical applicability. Conclusion CSCI patients have a higher risk of infection after cervical anterior decompression and fusion surgery, which is influenced by factors such as the time from injury to admission, preoperative use of hormone shock therapy, ASIA grading, SAA, and PCT. This early warning models has good predicative ability, can screen and identify high-risk populations and provide guidance for clinical prevention and control interventions. |
|
查看全文
下载PDF阅读器 |
| 关闭 |
|
|
|
